There’s more to orthodontics than simply moving teeth. Especially with children and adolescents, we also want to guide the development of the entire facial structure to solve certain types of malocclusions (poor bites).
One such concern involves the upper jaw and palate (roof of the mouth), known collectively as the maxilla. In some individuals, the maxilla is narrower than normal. This causes the upper teeth to fit abnormally inside the lower teeth when occluding or “biting down” and is known as a cross-bite. A cross-bite may restrict the amount of space for your teeth to erupt (appear in the mouth) in proper alignment. It can be so severe the individual may have to shift the jaw to one side to completely bite down.
If a cross-bite is caught early, there’s a non-surgical treatment to widen the maxilla and help prevent upper teeth misalignment. But there’s a limited time window of opportunity: this is because the maxilla is actually formed by two bones with a seam that runs down the middle of the palate. The two bones will eventually fuse, usually at the beginning of puberty; until then there’s a slight separation.
Before the bones fuse, we can use a palatal expander to widen this seam and encourage permanent bone growth in the resulting gap. The expander is made of two metal halves joined in the middle by a small screw device that fits between the teeth. You or your child turns the screw a very small amount once or twice a day with a special key and the action pushes the maxilla outward on either side: the slight tension created stimulates bone growth. Over time, the new bone will have added width to the maxilla and eliminated the cross-bite.
While it’s possible to correct this after the maxilla fuses, it will require surgery to separate the bones. The palatal expander helps us correct the problem in the most non-invasive way possible, but it must be done before puberty. Discovering this type of malocclusion early is one of many reasons why regular dental visits should be an important part of your child’s healthcare.
If you would like more information on palatal extenders, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Palatal Expanders.”